I recently saw a 33-year-old software engineer who was wearing old-technology polymacon spin-cast lenses. A long-time patient, he was compliant and showed up for his yearly examinations with meticulous accuracy (after all, he is an engineer).

Knowing more about contact lenses than all of us reading this article combined, he once again proceeded to tell me the benefits of not switching to newer high
Dk/t disposable contact lenses. We had the same discussion in previous years, so while he once again educated me about the finer points of enzyme tablets, I tuned him out and reviewed his preliminary testing findings.

Speaking Out

I turned white with angst as I read my technician's short but stabbing note:
"CLSNLA," or "contact lenses no longer available." As I completed my examination I prepared for the inevitable verbal lashing I was about to receive. Finally, after collecting all of my clinical data, I took a deep breath and just came out with it.

"Your old technology contact lenses are no longer available, and I'm going to refit you with newer, better, more breathable disposable contact lenses."

There ­ I said it. Now let the cards fall where they may.

"Okay, I thought you might say that one day," he replied.

"Huh?" I thought to myself. "That's it?" No academic brutalizing? You mean he's just going to let me do what's best for him?

While I certainly do not mean to offend the fine men and women of the engineering profession, they are often stereotyped as being more analytical and rigid in their thinking than the general population. Most of us in the eyecare trenches can relate to this personality type, which is why I chose it as my example.

This patient encounter exhibits what many of us, including myself that day, are continually guilty of: prescribing contact lenses based on a patient's personality and how we think he will respond to our recommendations.

Be the Doctor

Thinking that we will get "shot down" for recommending a new modality, many of us retreat and fall prey to a, "if it ain't broken, don't fix it" mentality.

In these cases, recognize that it really is broken. If you still think it isn't, then you should break it. After all, you owe it to your patients to prescribe what is best for them, regardless of their personality profile or your preconceived notion of how they will react to your suggestions.

Here are some ways to help you "break it."

Pretend the patient asked you about the contact lenses you want to prescribe for him. This changes your perception of your presentation from selling to telling. Practitioners tend to be great tellers, so capitalize on this communication skill.

Let your staff break the ice for you by asking the patient simple questions such as, "Did you know there is a non-surgical way to correct nearsightedness?" This can help decrease later obstacles to discussing
orthokeratology. To tell instead of sell, you can ask the patient, "Did you know there's a way to correct your vision without surgery?" When the patient replies, "Yes, I've heard a little about it from your staff," the door is now open for you to continue the discussion.

Don't Judge a Book by Its Cover

We often read that we should not prejudge a patient's ability to pay for a newer modality. So too we should not attempt to predict patients' reactions to something new based on their personality or how they might react to our recommendations.

Dr. Gerber is the president of the Power Practice ­ a company offering consulting, seminars and software solutions for optometrists. You can reach him at (800) 867-9303 or
DrGerber@PowerPractice.com.